Reorganizing Nursing Work on Surgical Units: A Time-and-Motion Study

Desjardins, France; Cardinal, Linda; Belzile, Éric; McCusker, Jane

doi:10.12927/cjnl.2008.20057

Cited by 40 publications

(43 citation statements)

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“…Previous studies have shown that nurses spend less time in these activities in units with similar characteristics to this study: medical clinic, 47.3% (19) ; medical-surgical, 50% (20) ; and surgical 55.7% (6) . Also, in others with divergent care profile and work dynamics: joint housing, 31% (21) ; emergency unit, 35% (22) ; and oncology outpatient clinic, 43.2% (5) .…”

Section: Discussionsupporting

confidence: 52%

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Workload of nurses: observational study of indirect care activities/interventions

Campos¹,

Oliveira²,

Perroca³

2018

Rev. Bras. Enferm.

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Objective: Observe the workfl ow of nurses in hospitalization units identifying indirect care activities/interventions; measure the frequency and average time spent in performing them; and to verify the associations between average time of the activities interventions grouped into categories and per hospitalization unit. Method: Observational exploratory study using the timed technique. It was conducted in medical, surgical and specialized clinic units of a teaching hospital in the northwest of São Paulo Brazil, with 16 attending nurses as participants. Results: 90 hours of observation were performed, of which 58% (52 hours and 10 minutes) were related to indirect care activities of the patients. The most frequent activities/interventions were: "Communication" -1,852 (44.1%), mean 34.6 (SD = 54); "Walking" -1,023 (24.3%), mean 22 (SD = 49.2); and "Documentation" -663 (15.8%), mean 82.7 (SD = 144.4). Conclusion: These fi ndings favor a redesign of the work process and foster the need to update and refi ne the current workload measurement instruments. Descriptors: Workload; Nursing care; Nursing; Time Management; Nursing Human Resources in Hospitals. RESUMO Objetivos:Observar o fl uxo de trabalho de enfermeiros em unidades de internação identifi cando atividades/intervenções de cuidado indireto; mensurar a frequência e o tempo médio despendido na realização das mesmas; e verifi car as associações entre o tempo médio das atividades/intervenções agrupadas em categorias e por unidade de internação. Método: Estudo exploratório observacional utilizando a técnica de tempos cronometrados. Foi conduzido em unidades de clínica médica, cirúrgica e especializada de um hospital de ensino do noroeste paulista, tendo como participantes 16 enfermeiros assistenciais. Resultados: Foram realizadas 90 horas de observação, sendo 58% (52 horas e 10 minutos) referentes às atividades de cuidado indireto ao paciente. As atividades/intervenções mais executadas constituíram-se em: "Comunicação" -1.852 (44,1%), média 34,6 (DP=54); "Deslocamento" -1.023 (24,3%), média 22 (DP=49,2); e "Documentação" -663 (15,8%), média 82,7 (DP=144,4). Conclusão: Esses achados favorecem o redesenho do processo de trabalho e fomentam a necessidade de atualização e refi namento dos instrumentos de mensuração de carga de trabalho atuais. Descritores:

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Section: Discussionsupporting

confidence: 52%

“…Studies measuring the time spent by nurses in performing their activities in different practice scenarios indicate a predominance of time consumed in indirect care activities, ranging from 43.2% (5) to 55.7% (6) . However, most PCIs address direct care activities.…”

Section: Introductionmentioning

confidence: 99%

Workload of nurses: observational study of indirect care activities/interventions

Campos¹,

Oliveira²,

Perroca³

2018

Rev. Bras. Enferm.

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“…[8][9][10] These studies quantify how nurses spend their time (direct care, indirect care, nonnursing, and personal time) and where they spend their time (patient room, nursing station, on unit, and off the unit). Understanding complex nursing work is a concern voiced by the Committee on the Work Environment for Nurses and Patient Safety with the Institute of Medicine (IOM).…”

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confidence: 99%

Using a Task Analysis to Describe Nursing Work in Acute Care Patient Environments

Battisto

Pak

Wood

et al. 2009

JONA: The Journal of Nursing Administration

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To improve the healthcare environment where nurses work and patients receive care, it is necessary to understand the elements that define the healthcare environment. Primary elements include (a) the occupants of the room and what knowledge, skills, and abilities they bring to the situation; (b) what tasks the occupants will be doing in the room; and (c) the characteristics of the built environment. To better understand these components, a task analysis from human factor research was conducted to study nurses as they cared for hospitalized patients. Multiple methods, including a review of nursing textbooks, observations, and interviews, were used to describe nurses' capabilities, nursing activities, and the environmental problems with current patient room models. Findings from this initial study are being used to inform the design and evaluation of an inpatient room prototype and to generate future research in improving clinical environments to support nursing productivity.

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“…Observational studies have been conducted on medical and nursing professions, but less so in allied health professions, and only one focusing on dietetics . Yet, this type of methodology can yield rich data on the internal processes within an organisation.…”

Section: Introductionmentioning

confidence: 99%

Day‐to‐day activities of clinical dietitians working in the inpatient and outpatient settings in a group of New South Wales public hospitals: The results of a direct observational study

Milosavljevic

Noble

Zaremba

2014

Nutrition & Dietetics

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Aim:To describe the daily tasks undertaken by dietitians working within the inpatient and outpatient sectors within the NSW public hospital system. Methods: This study used an ethnographic methodology that employed a direct, non-participatory, discontinuous, observational technique to observe hospital dietitians, in both outpatient and inpatient settings, during a typical work shift. Trained volunteer observers collected the data over a three-year period (2008, 2009 and 2010). The data were combined and then sorted into five categories including: direct patient care, indirect patient care, communication, administration and education of self or others. Results: A total of 609 hours and 21 minutes were observed across a three-year time period 2008-2010. On average, the dietitians in both inpatient and outpatient settings spent 18.3-32.2% of their time in direct patient care activities. The majority of time was spent in indirect patient care activities such as: information collection, documentation and discussion with other health-care professionals. A comparison between the two work settings showed that those dietitians working in the inpatient setting spent less time in direct patient care (18.3% vs 33.1%, P < 0.05), and more time in indirect care activities (41.7% vs 23.3%, P < 0.05) and in communication about patient care (22.7% vs 14.4%, P < 0.05). Conclusions:The findings show that dietitians spend most of their time doing activities that support patient care, but these activities occur away from the patient.

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Reorganizing Nursing Work on Surgical Units: A Time-and-Motion Study

Cited by 40 publications

References 0 publications

Workload of nurses: observational study of indirect care activities/interventions

Workload of nurses: observational study of indirect care activities/interventions

Using a Task Analysis to Describe Nursing Work in Acute Care Patient Environments

Day‐to‐day activities of clinical dietitians working in the inpatient and outpatient settings in a group of New South Wales public hospitals: The results of a direct observational study

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